SF 2377

1st Engrossment - 85th Legislature (2007 - 2008) Posted on 12/15/2009 12:00am

A bill for an act
relating to health; modifying basic life support ambulance staffing requirements
under certain circumstances; allowing a hardship waiver of advanced life support
ambulance staffing requirements; modifying advanced life support ambulance
staffing requirements under certain circumstances; amending Minnesota Statutes
2006, section 144E.101, subdivision 7; Minnesota Statutes 2007 Supplement,
section 144E.101, subdivision 6.

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:

Section 1.

Minnesota Statutes 2007 Supplement, section 144E.101, subdivision 6,
is amended to read:

Subd. 6.

Basic life support.

(a) Except as provided in deleted text begin paragraph deleted text end new text begin paragraphs
new text end (e) new text begin and (f) new text end , a basic life support ambulance shall be staffed by at least two deleted text begin ambulance
service personnel, at least one of which must be an EMT, who deleted text end new text begin EMTs, one of whom must
accompany the patient and new text end provide a level of care so as to ensure that:

(1) life-threatening situations and potentially serious injuries are recognized;

(2) patients are protected from additional hazards;

(3) basic treatment to reduce the seriousness of emergency situations is administered;
and

(4) patients are transported to an appropriate medical facility for treatment.

(b) A basic life support service shall provide basic airway management.

(c) deleted text begin By January 1, 2001, deleted text end A basic life support service shall provide automatic
defibrillation, as provided in section 144E.103, subdivision 1, paragraph (b).

(d) A basic life support service licensee's medical director may authorize the
ambulance service personnel to carry and to use medical antishock trousers and to perform
intravenous infusion if the ambulance service personnel have been properly trained.

(e) Upon application from an ambulance service that includes evidence
demonstrating hardship, the board may grant a variance from the staff requirements in
paragraph (a) and may authorize a basic life support ambulance to be staffed by one EMT
and one first responder new text begin driver for all emergency ambulance calls and interfacility transfers new text end .
The variance shall apply to basic life support ambulances operated by the ambulance
service until the ambulance service renews its license. When a variance expires, an
ambulance service may apply for a new variance under this paragraph. For purposes of this
paragraph, "ambulance service" means either an ambulance service whose primary service
area is located outside the metropolitan counties listed in section 473.121, subdivision 4,
and outside the cities of Duluth, Mankato, Moorhead, Rochester, and St. Cloud; or an
ambulance service based in a community with a population of less than 1,000.

new text begin (f) After an initial emergency ambulance call, each subsequent emergency
ambulance response, until the initial ambulance is again available, and interfacility
transfers, may be staffed by one registered first responder driver and an EMT. The EMT
must accompany the patient and provide the level of care required in paragraph (a). This
paragraph applies only to an ambulance service whose primary service area is located
outside the metropolitan counties listed in section 473.121, subdivision 4, and outside the
cities of Duluth, Mankato, Moorhead, Rochester, and St. Cloud, or an ambulance based in
a community with a population of less than 1,000 persons.
new text end

Sec. 2.

Minnesota Statutes 2006, section 144E.101, subdivision 7, is amended to read:

Subd. 7.

Advanced life support.

(a) new text begin Except as provided in paragraphs (f) and (g),
new text end an advanced life support ambulance shall be staffed by at least:

(1) one EMT and one EMT-P;

(2) one EMT and one registered nurse who is an EMT, is currently practicing
nursing, and has passed a paramedic practical skills test approved by the board and
administered by a training program; or

(3) one EMT and one physician assistant who is an EMT, is currently practicing as a
physician assistant, and has passed a paramedic practical skills test approved by the board
and administered by a training program.

(b) An advanced life support service shall provide basic life support, as specified
under subdivision 6, paragraph (a), advanced airway management, manual defibrillation,
and administration of intravenous fluids and pharmaceuticals.

(c) In addition to providing advanced life support, an advanced life support service
may staff additional ambulances to provide basic life support according to subdivision
6 deleted text begin . When routinely staffed and equipped as a basic life support service according to
subdivision 6 deleted text end and section 144E.103, subdivision 1 deleted text begin , the vehicle shall not be marked
as advanced life support deleted text end .

(d) An ambulance service providing advanced life support shall have a written
agreement with its medical director to ensure medical control for patient care 24 hours
a day, seven days a week. The terms of the agreement shall include a written policy
on the administration of medical control for the service. The policy shall address the
following issues:

(i) two-way communication for physician direction of ambulance service personnel;

(ii) patient triage, treatment, and transport;

(iii) use of standing orders; and

(iv) the means by which medical control will be provided 24 hours a day.

The agreement shall be signed by the licensee's medical director and the licensee or
the licensee's designee and maintained in the files of the licensee.

(e) When an ambulance service provides advanced life support, the authority
of an EMT-P, Minnesota registered nurse-EMT, or Minnesota registered physician
assistant-EMT to determine the delivery of patient care prevails over the authority of
an EMT.

new text begin (f) Upon application from an ambulance service that includes evidence
demonstrating hardship, the board may grant a variance from the staff requirements in
paragraph (a), clause (1), and may authorize an advanced life support ambulance to be
staffed by a first responder driver with a paramedic for all emergency calls and interfacility
transfers. The variance shall apply to advanced life support ambulance services until the
ambulance service renews its license. When the variance expires, an ambulance service
may apply for a new variance under this paragraph. This paragraph applies only to an
ambulance service whose primary service area is located outside the metropolitan counties
listed in section 473.121, subdivision 4, and outside the cities of Duluth, Mankato,
Moorhead, Rochester, and St. Cloud, or an ambulance based in a community with a
population of less than 1,000 persons.
new text end

new text begin (g) After an initial emergency ambulance call, each subsequent emergency
ambulance response, until the initial ambulance is again available, and interfacility
transfers, may be staffed by one registered first responder driver and an EMT or paramedic.
This paragraph applies only to an ambulance service whose primary service area is located
outside the metropolitan counties listed in section 473.121, subdivision 4, and outside the
cities of Duluth, Mankato, Moorhead, Rochester, and St. Cloud, or an ambulance based in
a community with a population of less than 1,000 persons.
new text end